PMID- 9389688
OWN - NLM
STAT- MEDLINE
DCOM- 19971229
LR  - 20220321
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 90
IP  - 12
DP  - 1997 Dec 15
TI  - Transplantation of filgrastim-mobilized peripheral blood stem cells from 
      HLA-identical sibling or alternative family donors in patients with hematologic 
      malignancies: a prospective comparison on clinical outcome, immune 
      reconstitution, and hematopoietic chimerism.
PG  - 4725-35
AB  - The clinical results, cellular immune reconstitution, and hematopoietic chimerism 
      obtained after transplantation of recombinant human granulocyte 
      colony-stimulating factor mobilized allogeneic peripheral blood stem cells 
      (PBSCs) from genotypically human leukocyte antigen (HLA)-identical sibling (n = 
      36) or alternative family donors (n = 24) were prospectively compared in patients 
      with hematologic malignancies. Thirty-two of 34 evaluable patients with 
      HLA-identical sibling donors and all patients with alternative family donors 
      achieved trilineage engraftment. The median time intervals to reach peripheral 
      neutrophil counts <500/microL (13 v 17 days) or <1,000/microL (16 v 19 days) and 
      unsupported platelet counts <20,000/microL (11 v 15 days) or <50, 000/microL (19 
      v 24 days) as well as red blood cell and platelet transfusion requirements were 
      not significantly different between both patient subsets. The cumulative 
      probability of grades II through IV acute graft-versus-host disease (GVHD) for 
      the 60 study patients was 48% +/- 10% but ranged between 86% +/- 12% in patients 
      whose donors had at least one HLA-A,B,DR,DQ,DP antigen disparity in direction to 
      acute GVHD, and 25% +/- 9% in recipients of GVHD-matched transplants (P < .003). 
      The 2-year survival estimates were 54% +/- 10% for patients with alternative 
      family donors and 65% +/- 9% for patients with HLA-identical sibling donors. 
      Multivariate analysis identified the pretransplantation disease stage, patient 
      age, and acute GVHD as independent predictors of overall and disease-free 
      survival, whereas alternative family donors alone had no adverse effect on these 
      clinical endpoints. Monthly monitoring of peripheral blood T-helper cell subsets, 
      B cells, and monocytes during the first year posttransplantation showed a nearly 
      identical course of immune cell reconstitution in both patient subsets. In 
      addition, no differences in the proportions of complete chimeric patients were 
      detectable between the two patient subsets by sex chromosome and variable number 
      of tandem repeats analysis up to 12 months posttransplantation. In conclusion, 
      PBSCs from alternative family donors represent an attractive source for 
      allogeneic transplantation in patients lacking HLA-identical sibling donors and 
      should be further evaluated in comparison with marrow transplants from 
      alternative family donors.
FAU - Beelen, D W
AU  - Beelen DW
AD  - Department of Bone Marrow Transplantation, University Hospital of Essen, Essen, 
      Germany.
FAU - Ottinger, H D
AU  - Ottinger HD
FAU - Elmaagacli, A
AU  - Elmaagacli A
FAU - Scheulen, B
AU  - Scheulen B
FAU - Basu, O
AU  - Basu O
FAU - Kremens, B
AU  - Kremens B
FAU - Havers, W
AU  - Havers W
FAU - Grosse-Wilde, H
AU  - Grosse-Wilde H
FAU - Schaefer, U W
AU  - Schaefer UW
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (Recombinant Proteins)
RN  - 143011-72-7 (Granulocyte Colony-Stimulating Factor)
RN  - PVI5M0M1GW (Filgrastim)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Child
MH  - Child, Preschool
MH  - Chimera
MH  - Female
MH  - Filgrastim
MH  - Graft vs Host Disease/etiology
MH  - Granulocyte Colony-Stimulating Factor/*pharmacology
MH  - Hematologic Neoplasms/immunology/mortality/*therapy
MH  - *Hematopoietic Stem Cell Mobilization
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Histocompatibility Testing
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Polymerase Chain Reaction
MH  - Prospective Studies
MH  - Recombinant Proteins
MH  - Survival Rate
MH  - *Transplantation, Homologous
EDAT- 1998/01/07 00:00
MHDA- 1998/01/07 00:01
CRDT- 1998/01/07 00:00
PHST- 1998/01/07 00:00 [pubmed]
PHST- 1998/01/07 00:01 [medline]
PHST- 1998/01/07 00:00 [entrez]
AID - S0006-4971(20)54935-5 [pii]
PST - ppublish
SO  - Blood. 1997 Dec 15;90(12):4725-35.